Uterine artery embolization versus myomectomy: a multicenter comparative study
Objective
To determine whether there is significant quality of life score improvement after uterine artery embolization (UAE) and to compare UAE and myomectomy outcomes.
Design
Prospective cohort controlled study.
Setting
Sixteen medical centers in the United States.
Patient(s)
One hundred forty-nine UAE patients and 60 myomectomy patients. Patients were assigned to myomectomy or UAE on the basis of a best treatment decision made by the patient and her physician. All patients were observed for 6 months. The UAE patients also had follow-up examinations at 1 year.
Intervention(s)
Myomectomy or UAE.
Main Outcome Measure(s)
Quality of life score changes, menstrual bleeding score changes, uterine size differences, time off, and adverse events.
Result(s)
Both groups experienced statistically significant improvements in the uterine fibroid quality of life score, menstrual bleeding, uterine volume, and overall postoperative quality of life. The mean hospital stay was 1 day for the UAE patients, compared with 2.5 days for the myomectomy patients. The UAE and myomectomy patients returned to their normal activities in 15 days and 44 days, respectively, and returned to work in 10 days and 37 days, respectively. At least one adverse event occurred in 40.1% of the myomectomy patients, compared with 22.1% in the UAE group.
Conclusion(s)
The uterine fibroid quality of life score was significantly improved in both groups. No significant differences were observed in bleeding improvement, uterine volume reduction, uterine fibroid quality of life score improvement, and overall quality of life score improvement between groups. Patients receiving UAE required fewer days off work, fewer hospital days, and experienced fewer adverse events.
Key Words: Embolization , fibroid , leiomyoma
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S.C.G. has received funding from and is a consultant for Boston Scientific Corporation. This study was funded by grants from Boston Scientific Corporation.The UAE vs. Myomectomy Study Group: Paul R. Dong, M.D., and Michael S. Broder, M.D., David Geffen School of Medicine at University of California-Los Angeles; Richard W. Tureck, M.D., Hospital of the University of Pennsylvania; John C. Lipman, M.D., Radiology Associates of Atlanta; Gary P. Siskin, M.D., Albany Medical Center; John L. Nosher, M.D., and Gloria A. Bachmann, M.D., Robert Wood Johnson Medical Center; Merle H. Barth, M.D., and Amy E. Young, M.D., The Methodist Hospital; Mahmood K. Razavi, M.D., and Bertha H. Chen, M.D., Stanford University Medical Center; Theodore P. Chambers, M.D., and Glenna R. Anderson, M.D., Fairfax Hospital; Robert L. Worthington-Kirsch, M.D., Roxborough Memorial Hospital; Lynda T. Thomas, M.D., Chestnut Hill Hospital; Richard A. Reed, M.D., and Shafeeq S. Shamsid-Deen, M.D., Huntington Memorial Hospital; Keith M. Sterling, M.D., and Barry S. Rothman, M.D., INOVA Alexandria Hospital; Gerald A. Niedzwiecki, M.D., Mease Hospital; Elizabeth A. Stewart, M.D., Brigham and Women’s Hospital; Linda D. Bradley, M.D., Cleveland Clinic Foundation; Timothy R. Yeko, M.D., The Reproductive Medicine Group.The UAE vs. Myomectomy Study Group Clinical Events Committee: James B. Spies, M.D., Georgetown University Medical Center; Douglas M. Coldwell, Ph.D., M.D., University of Mississippi; Keith B. Isaacson, M.D., MIGS Center at Newton Wellesley Hospital.The UAE vs. Myomectomy Study Group Core Laboratory: Reena C. Jha, M.D., Georgetown University Medical Center; Susan M. Ascher, M.D., Georgetown University Medical Center.
PII: S0015-0282(05)03656-3
doi:10.1016/j.fertnstert.2005.05.074
© 2006 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
